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General NPI Number Information
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NPI Number | 1659661155
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Entity Type | Organization
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Legal Business Name | DALLAS OREGON EMERGENCY PHYSICIANS LLC
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Dates
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Enumeration Date | 04/18/2011
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Last Update Date | 09/28/2023
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Provider Practice Location Address
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Address Line | 525 SE WASHINGTON ST
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City | DALLAS
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State | OR
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Zip | 97338-2834
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Country | US
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Telephone | 973-251-1132
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 98585
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City | LAS VEGAS
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State | NV
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Zip | 89193-8585
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OFFICER
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Name | KAREN VAUGHN
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Credential |
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Telephone | 973-251-1132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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